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How to Have a Good Knee Replacement

Artificial joint replacement is the last resort for most people when their knees have worn out.

Fortunately, the procedure itself has become much less painful, far quicker, and more accurate; and it has a faster recovery time than ever before.

However, there are several key steps you can take before, during and after the surgery to help control the outcome.

BEFORE THE SURGERY

Depending on your exam, x-rays and MRI, these may include a great physical therapy with gait, balance and muscle training; biologic joint replacement procedures with meniscus replacement and articular cartilage repair, if there is still joint space to work with; or partial joint replacement, if only one or two portions of the knee are worn out. Partial knee replacements work much better than in the past due to computer and robotic insertion techniques that have taken the inaccuracy out of the procedure.

Prepare mentally. If you need a total knee replacement, look at the procedure as an opportunity to become fitter, faster and stronger than you have been in years. This is not usually possible when you are having pain, but it is a great goal to have once the knee pain is gone. Looking forward to the “new you” makes the experience much less worrisome and turns it into a positive event in your life.

Line up a physical therapist (PT), a trainer, a massage therapist and a nutritionist. All people with significant knee arthritis have walked for years with a limp, have decreased range of motion in their knee and often have compensated with abnormal gaits, decreased back and hip motion. Focus your pre-surgery efforts on increasing range of motion, developing exercise routines focused on trunk and core strengthening.

See a nutritionist to help ensure that your dietary intake of protein is sufficient to respond to the stress of surgery. A low protein level in the blood correlates with increased infection at surgery so protein matters. Optimizing your weight before and after surgery helps you achieve the goals of being fitter, faster and stronger and preserve your new joint.

The night before your procedure, go see a movie or watch a comedy. Relax, laugh and sleep well.

DURING THE SURGERY

The day of surgery, smile. Having a confident calm positive attitude affects you and your surgical team. Be confident that you are in safe hands, you’re going to have a really good nap and in a few minutes, you’ll have a new knee.

If you are anxious, consider a guided meditation.

AFTER THE SURGERY

Set aside time to focus on physical therapy the day after surgery and everyday. A great PT will help work on the entire body, restoring each body part to work together. Some PTs will focus on training and fitness but others may not have the time or insurance permission to do so. Take enough time off work to get into the PT clinic as often as possible in the first six weeks. While some surgeons don’t believe PT helps, we are adamantly in the opposite camp.

Consider having a fitness trainer at a gym or have one come to your home. It is most important to see yourself as an athlete in training and not a patient in rehab. Focus on building muscle strength in your upper body, trunk and core as well as the lower extremities.

Book regular massages. A massage therapist can often augment the work the PT does and keep your tissues flexible while your joint heals and your body retrains. Treat yourself as any pro athlete would, use all the tools of the fitness trade.

Self massage works too. Nutrition is often common sense with a new focus on increasing protein and water intake, decreasing carbohydrates, and exercising more than you eat.

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